Bioethics Starts with Telling the Truth

Faith informs a University of Pennsylvania professor's pondering of life and death

Many bioethicists work in academia, removed from daily life and media buzz. But Arthur L. Caplan, director of the Center for Bioethics at the University of Pennsylvania in Philadelphia, is not a typical bioethicist.

A columnist for MSNBC's website, Caplan writes for popular media on topics ranging from the human genome project to organ transplants. Unlike most of his colleagues, Caplan enjoys talking to the media--from his home, in his office or from his cell phone in his car. "If you want to get the public talking about bioethics, you have to sell it!" Caplan said.

During an average week, Caplan said, "I work with a wide range of groups. I'll talk to NASA (about research the agency is conducting on astronauts). A company will call about the issue of genetically altered food. Or a religious group will contact me about a report they're doing on cloning."

But Caplan's impact isn't limited to the public sphere. His scholarly work has also influenced bioethics. He has written more than 400 articles for academic publications and more than 20 books. (In 1999, Caplan co-edited "The Ethics of Organ Transplants: The Current Debate" for Prometheus Books.)

Thomas Murray, president of The Hastings Center, a bioethics think tank in Garrison, N.Y., says of Caplan's impact on bioethics, "There are two sides to Art's impact. No one loves the media spotlight more than he does. I could see that 20 years ago when I worked with him at the Hastings Center. He's gotten bioethics into the public conversation." But, Murray adds, few people know "what a gifted scholar Art is. He's had an enormous impact on the intellectual debate."

At Brandeis University in Waltham, Mass., Caplan majored in philosophy and biology. After graduating from Brandeis in 1971, he studied philosophy at Columbia University in New York, earning his Ph.D. from Columbia in 1979. His doctoral dissertation, Caplan says, "had nothing to do with bioethics. It was about evolution. What made it science--as opposed to myth or religion."Though unaware of their influence at the time, two events in his childhood, Caplan says, informed his views on the value and role of bioethics. While growing up in Framingham, Mass., Caplan contracted polio at age 7. He spent a year in the hospital recovering from the illness. Today, at 50, he has no residual symptoms of polio. During his time in rehabilitation, Caplan recalls, "I saw a lot of kids who were permanently paralyzed from the polio. Kids would die. But, the nurses would lie to us. They'd say, `They've gone home.' We knew that wasn't true."

From this experience, Caplan says, he developed a sense of compassion for the downtrodden--poor people, disabled people, old people and minorities. It made him recognize the inequities in our health-care system, Caplan says. "Medicine doesn't treat people with incurable diseases well. There's no insurance for those with chronic illnesses." His time as a patient made Caplan aware that "doctors and health-care providers should tell their patients the truth."

His Jewish upbringing, Caplan says, also influenced his method of doing bioethics. He remembers, "I was raised in a Conservative (Jewish) temple. The rabbi set a tone that allowed for a great deal of discussion about the Torah, Talmud--about ethical issues. The moral concern--of how you live in your daily life--was important. We discussed Bible stories that told about personal conduct."

Caplan doesn't think of himself as being a religious Jew in the sense of observing ceremonies or rituals. But, he says, "Judaism's mode of intellectual argument is important to how I do bioethics."

Caplan got involved in bioethics inadvertently while a graduate student at Columbia University. One day, as a teaching assistant, he taught a class on evolution to some philosophy students. After his lecture, the (then) associate dean of Columbia's medical school spoke to him and offered Caplan a job teaching in a new medical ethics program at Columbia University College of Physicians and Surgeons. "I had no interest in medical ethics" Caplan recalled, "until the dean said I'd be paid for the work."

His first effort at teaching medical ethics, Caplan says, "failed miserably. I wasn't including any medical cases in the courses." To learn about medicine so he could teach medical ethics, Caplan spent a year as a special student at Columbia's medical school. He went with the medical students on rounds and on clinical rotations from neurology to rehabilitation. "This made me interested in bioethics," he says. "The hospital was like an ethics lab."

Today, at the Bioethics Center at the University of Pennsylvania, Caplan ponders complex issues from genetic testing to aging. On the human genome project Caplan says, "the mapping of human DNA isn't yet complete. But, during the next few years, it will raise many ethical problems. How is the privacy of genetic information going to be maintained? What's going to protect people from discrimination from employers and insurance companies?" He adds, "But should privacy always be maintained? Are there some circumstances where an employer should have the right to see an employee's genetic information--as in the case of an airline pilot with a genetic disposition to Alzheimer's disease?"